Let’s call a spade a spade here. Your Pediatrician is burnt out. Low insurance reimbursement, low salaries compared to other medical specialties, long hours, and the stress and worry of the job have led a lot of Pediatricians to cut their hours or leave the workforce. I speak with Dr. Elliston, a former colleague of mine and founder of @ellistonpediatrics. He left traditional pediatric medicine to start a large and thriving Concierge Medicine practice in NYC.

We discuss:

• Why doctors are burnt out and why the system is failing us and patients
• What are the benefits of concierge medicine
• How does it work with insurance and for emergencies

Find out more about Dr. Andrew Elliston at ellistonpediatrics.com or via Instagram @ellistonpediatrics

00;00;00;02 – 00;00;19;17

Dr. Andrew Elliston

The future of pediatric care, if not medicine in general in the United States especially, is going to have to shift. It’s going to be similar to the ideas we’re going to be talking about, because the current system is failing both patients and their families and the doctors.

 

00;00;19;19 – 00;00;42;24

Dr. Mona

Welcome back to the PedsDocTalk podcast. I’m really excited about this episode because I am inviting one of my former colleagues, Doctor Andrew Elliston, who is a general pediatrician, to talk about something that I don’t think a lot of you may have heard of. Or maybe you have. Concierge medicine. Is it the future of pediatrics? Thank you so much for joining me today, Andrew.

 

00;00;42;26 – 00;00;47;09

Dr. Andrew Elliston

You’re welcome. My pleasure. It’s, great to be able to talk to you again.

 

00;00;47;12 – 00;01;08;05

Dr. Mona

Well, me and Doctor Andrew, we work together at a private practice. When I first started working as a pediatrician, and he went on to start a concierge pediatric practice. And so I really wanted it on the podcast so that we can talk about what this is. Maybe this is something that you, listening may be interested in.

 

00;01;08;11 – 00;01;27;04

Dr. Mona

Maybe you are a pediatrician or, provider of some sort that wants to get into concierge medicine. So we really wanted to educate our listeners about what this is, the benefits and kind of why he went into it. So, Andrew, tell me more about yourself and why you started a concierge pediatric practice.

 

00;01;27;06 – 00;01;39;20

Dr. Andrew Elliston

Sure. So, I mean, as you know, because we did work together, I used to work in a traditional office based practice with a very high volume of patients and a full workload.

 

00;01;39;22 – 00;01;40;10

Dr. Mona

 

00;01;40;13 – 00;02;11;19

Dr. Andrew Elliston

And concierge medicine is a tricky term because it means different things for people. There’s no specific definition for it. So it can almost mean whatever you choose for it to mean for us in our practice. It really represents the idea that we have more availability. We can give more attention and more time for our patients, which results in basically just providing more thorough care in the office based practice.

 

00;02;11;21 – 00;02;36;14

Dr. Andrew Elliston

I was seeing 30 to 35 children a day, and I was responsible for 4 to 5000 kids in a year, which is busier than some practices out there. You experienced that as well. And although it was always important to me to focus on providing really high quality care and building strong relationships with the children and their families. That was really hard to do at that pace.

 

00;02;36;16 – 00;03;00;02

Dr. Andrew Elliston

And ultimately, I think it was turning out to be unsustainable for me as a pediatrician. And I was even burning out partly because I cared so much. I was investing so much of myself in the job and the schedule and doing it at that pace, and too many things were falling by the wayside, including ultimately, the care.

 

00;03;00;04 – 00;03;22;00

Dr. Mona

Oh, I agree with that. And on this episode we also have your partner who is also your business partner, which is amazing. Heidi. Welcome. Hi. How are you? So Heidi is also a labor and delivery nurse who works as part of Elliston Pediatrics, which is this pediatric practice that we’re talking about on this episode. Again, thank you for joining us as well.

 

00;03;22;03 – 00;03;45;22

Dr. Mona

Thank you for inviting us. And I think you can agree to obviously, watching Andrew be in private practice and then now being in concierge medicine, what he’s describing with that workload and what that does to us also bringing that home. Like do you see a difference in him having started a concierge practice versus doing traditional, you know, medicine where we see a volume of patient like that?

 

00;03;45;25 – 00;04;15;00

Dr. Mona

Yeah, it was actually my idea. Amazing. He. Andrew, his dad is a doctor. His sister is the doctor. His uncles are doctors. And I think when you grow up in that family dynamic. And that’s all, you know, medicine is really all you know, and you want to be the best doctor that you can be. Sometimes I feel like you don’t notice necessarily how difficult it is.

 

00;04;15;01 – 00;04;36;21

Dr. Mona

You know, like, I really, truly feel like a lot of doctors go into it wanting to, like, save the world. And I’m going to make a difference and it’s going to be so awesome. And then you get working in a practice and seeing 35 kids a day, or patients of any kind, you know, adults too, and you do it every day and you almost kind of get into this routine.

 

00;04;36;21 – 00;05;03;00

Dr. Mona

You don’t necessarily notice how that’s affecting your personal life. And he was really burning out and probably not realizing it. Or I definitely not realizing it lost like 10 pounds. And I was just like sitting there and thinking like, a human being should not have to work that hard and still feel like they’re not doing their best. Yeah, right.

 

00;05;03;06 – 00;05;22;02

Dr. Mona

And so I was like, man, and I’m a mom, you know, we have two kids together and I’m the patient side. I was also seeing the effects of the health care system the way it is right now for our own kids. And I just talked to them and I’m like, hey, let’s do something different like this. There’s got to be a better way.

 

00;05;22;08 – 00;05;44;12

Dr. Mona

This is not sustainable. So that’s how the idea got started. Yeah. And I think we can talk so much about the benefits from our end as the doctor in terms of our mental health, quality of life. I mean, we’ll talk more about what this concierge pediatrics is and you know, how it benefits your patients in a bit, but 100%.

 

00;05;44;12 – 00;06;08;14

Dr. Mona

I mean, I can attest to this, too. I mean, I’m not in concierge, but I’ve been in private practice now for seven years, and it drains you. And I, like you said, I went out of residency like, this is going to be great. I’m going to make a difference. And then you’re realizing that when you’re seeing so much volume, you actually can’t make a difference, because how are you able, like you said, Andrew, like to be able to do the quality and the time with 30, 40 people.

 

00;06;08;14 – 00;06;27;23

Dr. Mona

You don’t have that much time in a day. You know, you really don’t. And then you get burnt out and then you lose the joy that you have. I mean, this is kind of why I started my podcast, and everything else is because of burnout. We do things because we want to reclaim our joy for our practice and our trade, which for me and you, Andrew, is pediatric medicine.

 

00;06;27;23 – 00;06;50;01

Dr. Mona

So I, you know, really resonate with that. And I know you started this late 2018 and we’re recording this in 2022. So it’s been a long journey through the pandemic as well. What would you say some of the benefits of concierge medicine has been? And you can if you want to reword that. I mean, I know you said that that term can be used differently, but what exactly is concierge medicine?

 

00;06;50;01 – 00;06;53;26

Dr. Mona

What does it look like? How does it benefit patients? Would be my first question.

 

00;06;53;28 – 00;07;06;17

Dr. Andrew Elliston

Sure. So very much. I think that the future of pediatric care, if not medicine in general in the United States, especially, is going to have to shift.

 

00;07;06;20 – 00;07;06;28

Dr. Mona

 

00;07;07;05 – 00;07;26;20

Dr. Andrew Elliston

It’s going to be similar to the ideas we’re going to be talking about, because the current system is failing both patients and their families and the doctors. Basically, we feel like families all deserve the level of care that we currently are able to provide. But that’s not how the system is set up.

 

00;07;26;22 – 00;07;27;08

Dr. Mona

 

00;07;27;10 – 00;07;58;08

Dr. Andrew Elliston

I also think that doctors want to be able to provide that kind of care, but they’re also not able to because that’s not how the system is set up. All the reimbursements from insurance companies and incentives are flipped on their head. And preventative care or primary care honestly, just kind of gets the short end of the system stick, and the incentive for better prevention and better quality of care is not really there is not built into the system.

 

00;07;58;11 – 00;08;34;27

Dr. Andrew Elliston

So our practice is our personal attempt to change that whole system for the better, at least doing our part in our corner to do that and for the patients. I think that the key in pediatrics especially, is that prevention and just overall preventative care is the most important piece. And the benefits that we’re able to provide our patients and families with our style of practice is that they get ready and direct access to their doctor whenever they need it.

 

00;08;34;29 – 00;08;41;23

Dr. Andrew Elliston

They can text a question to us and get answers in seconds or minutes. Most of the time directly from the doctor.

 

00;08;41;28 – 00;08;42;22

Dr. Mona

 

00;08;42;24 – 00;09;13;08

Dr. Andrew Elliston

We focus a lot on empowering families, helping them with lots of education at every visit between visits, helping them understand developmental stages and milestones that are either already happening or are going to be happening and we find that giving all of that preparation and empowerment, really to the parents, goes a long ways towards reducing the level of stress in their lives.

 

00;09;13;09 – 00;09;14;00

Dr. Mona

Yeah.

 

00;09;14;02 – 00;09;33;29

Dr. Andrew Elliston

Improving the quality of their lives, the quality of the health care. It just all together as a bundle. It’s really, really helpful. And because we can give so much time to each patient with this style of practice, we can, you know, our well visits are routinely an hour long.

 

00;09;34;01 – 00;09;34;25

Dr. Mona

Well, yeah.

 

00;09;34;27 – 00;09;49;11

Dr. Andrew Elliston

In an office, if it lasts 15 minutes, you’re lucky. And even then the schedule may not accommodate it. You know, I’ve been there in that hour long visit that I might have with one of my patients, which I did a few times already this morning.

 

00;09;49;13 – 00;09;50;01

Dr. Mona

 

00;09;50;23 – 00;10;12;07

Dr. Andrew Elliston

Is all with me. I’m doing the measurements, I’m doing the exam, I’m doing the vaccines, I’m doing all the tests and I’m talking to the family the whole time. And I’m watching the child play and I can get a lot more done in that hour than most people might realize. And you can’t possibly do that in an office setting, especially in 15 minutes.

 

00;10;12;09 – 00;10;36;27

Dr. Andrew Elliston

So all of this prevention and preparation and ongoing contact with the families also helps do things like reduce visits to the E.R. or the urgent care. A lot of times an issue comes up and if they reach out and we’re involved from the beginning, as soon as a child starts to get sick or gets injured or whatever the other concern may be.

 

00;10;37;21 – 00;11;03;11

Dr. Andrew Elliston

And help manage it. Stay on top of it. Check in with them multiple times a day, each day if we need to. And because of that we can avoid the need to suddenly need to see a specialist or to take medications that we could have avoided. And in a regular office where you can’t have that kind of access to the doctor, and that time, you often wind up in the E.R. unnecessarily without knowing any better.

 

00;11;03;13 – 00;11;30;04

Dr. Mona

Yeah. You mentioned how, with this whole model, right? The patient and family has more access to their doctor because, of the way that this is set up. And we’ll get into more about, like, how this works with, you know, the, monthly fee insurance emergencies, all of that. But I also find that because you have more time with your patients, like you said, like sometimes hour, maybe even more, like you said, you’re able to give them more education about development.

 

00;11;30;04 – 00;11;50;18

Dr. Mona

You’re able to give them so much more in between visits. Do you even see them calling so often? Like one thing I, you know, I think people will think like, well then if you do concierge medicine, your phone must be like off the hook all the time because everyone’s calling. But my issue with modern mint, like in working where I do, is because I don’t get a lot of time right.

 

00;11;50;18 – 00;12;13;04

Dr. Mona

Of course, parents are going to feel like, oh crap, I had a question I had to ask the doctor and I forgot. So then we tend to get more questions in between visits versus if we had more time at the actual visit, we would be able to talk about and to our guidance what to expect until the next visit calmly, with time, which could limit the amount of all these questions that come in in between visits.

 

00;12;13;05 – 00;12;17;18

Dr. Mona

Do you find that that happens because you’re able to provide more time for your patients?

 

00;12;17;20 – 00;12;42;13

Dr. Andrew Elliston

It’s a good question. Yes, it does go a long ways towards reducing the number of questions and maybe the work I have between appointments, because I invest that time is right. I choose to invest that time with the appointments, with the families. That’s not to say I don’t get a lot of questions between appointments, but I’ll often it’s just a quick 1 or 2 off question by text.

 

00;12;42;13 – 00;13;03;07

Dr. Andrew Elliston

We have like a secure messaging app that our families use with us, and I do answer questions from numerous families each day, but I actually get very few phone calls. They know to call if they really have an urgent issue and they need to reach me. But my phone is not ringing off the hook. Yeah, right. You can relate to this.

 

00;13;03;07 – 00;13;13;24

Dr. Andrew Elliston

When we worked in that busy practice together the nights I was on call. I mean, the number of phone calls I would get even overlapping each other was almost impossible to tally.

 

00;13;13;29 – 00;13;14;18

Dr. Mona

Yeah.

 

00;13;14;21 – 00;13;49;29

Dr. Andrew Elliston

Per night. This is very, very different. Our families can reach us. We don’t have as many families to take care of, and that’s part of the difference. But the other part is we do provide a lot of education and preparation and support, and the families partly know that they can reach us whenever they want or need to. And that takes a lot of the urgency out of calls that happen, like in the middle of the night or, you know, basically in an office where you might call, talk to a secretary who passes a message to the nurse, who then passes a message to the doctor, and then it reverses.

 

00;13;49;29 – 00;14;10;08

Dr. Andrew Elliston

The doctor tells the nurse who tells the secretary, yeah, I’m like, back. That might even take 2 or 3 days. And by then the situation may already be different. We cut all of that out, and because the parents know that they can reach us whenever they need to. They end up not needing to as much. Right? Like they need to as much.

 

00;14;10;11 – 00;14;32;25

Dr. Mona

Well, I know every concierge, pediatric practice, concierge, medicine practice, you know, may look a little bit different, like you said. So in pediatrics, your model, you’re based in New York. And how does it work with you know, you said you go to people’s homes. I know sometimes some people have a brick and mortar office, but you really are prioritizing or doing the at home visit.

 

00;14;33;00 – 00;14;38;24

Dr. Mona

What is your radius of like where you see patients? What part of New York you see? Patients for.

 

00;14;38;26 – 00;15;04;12

Dr. Andrew Elliston

Sure. So, you know, partly New York City is a fairly unique environment, but for the most part the idea is easy to understand. I travel basically all over the island of Manhattan, across the bridge a little bit over into Brooklyn. But for the most part it’s all of Manhattan, the island itself, and mostly more downtown. I travel however I need to get there.

 

00;15;04;14 – 00;15;14;13

Dr. Andrew Elliston

I walk sometimes, I’ve done it for miles a day. I will take the subway. I’ll take a taxi or Uber. Most of the time these days I actually bike around to my patients.

 

00;15;14;17 – 00;15;15;15

Dr. Mona

Amazing.

 

00;15;15;17 – 00;15;40;26

Dr. Andrew Elliston

No matter the weather, which sometimes I question. But yes. So part of the issue with concierge medicine is that it can mean a lot of different things. Some people build a practice that is an actual office and the patients come to them, but they get maybe more time and more attention for us. We actually don’t have a physical office where we see patients.

 

00;15;40;29 – 00;15;59;20

Dr. Andrew Elliston

We go to the patient’s home for all appointments, and that is a little bit unique to us. Some might even do a hybrid of some house visits and mostly office visits, but we’ve chosen to go all in on the house call version, so we’re bringing that back.

 

00;15;59;22 – 00;16;18;21

Dr. Mona

Amazing. And like you said from a developmental standpoint, like you’re watching the child play in their own environment, the family is not having to wait in a waiting room that’s germy like they are in their own space. So I imagine the family and the child maybe even more comfortable than, you know, having to love them all across the city.

 

00;16;18;24 – 00;16;39;14

Dr. Andrew Elliston

Yeah, I mean, they are as a parent, you know, that even just going to the grocery store with your kid is. Yeah, it’s a process. And so, yeah, it’s a very different feeling to spend the time with the family. It feels like as a guest and watch the child interact with the child in their home environment. I get to see them play with their toys.

 

00;16;39;17 – 00;16;56;01

Dr. Andrew Elliston

I get to meet their pets, which in an office I may have never even realize they had a pet. Yeah, I can look at the crib and tell them, no, no, you have to take these bumpers off the crib. It’s not safe. I wouldn’t have known that unless they showed me a picture in the office, which is hard to do in 10 or 15.

 

00;16;56;02 – 00;16;57;06

Dr. Mona

Yes.

 

00;16;57;08 – 00;17;12;28

Dr. Andrew Elliston

And they’re much more comfortable. It’s true. You know, when I have to give a vaccine to a child, which we do all the time, they can immediately turn around and play with their toys, or go to their room or cuddle with their parents on their couch, and they’re already in their safe space. Right?

 

00;17;13;00 – 00;17;41;25

Dr. Mona

You know, one thing that I would say to one of the reasons that we decided to do house calls is from the mother’s point of view, as I said, I’m a labor and delivery nurse and a mom of two kids, and it never really made sense to me that moms who have just gone through a delivery and are still recovering, whether it’s a vaginal delivery or a C-section or whatever, they’re still recovering.

 

00;17;41;25 – 00;18;10;08

Dr. Mona

And now you’re asking them to go to a pediatric practice, go to an office, you know, log their kids there, and sometimes they can’t sit because they’re still feeling, you know, painful or, you know, or they’re breastfeeding or they’re it’s just such a wonderful time that we want our practice to be families Center where we’re catering. Yes, we’re a pediatric practice.

 

00;18;10;08 – 00;18;31;14

Dr. Mona

We are there for the children, but we definitely realize that if we don’t make things easier and better and safer and more supportive for the parents, then the kids are not getting the best benefits that they can, right? Like the parents. It’s like that idea of like putting the oxygen mask when the plane, you know. Yeah, I knew first.

 

00;18;31;14 – 00;18;58;16

Dr. Mona

I’m a true believer of that, that parents need to be supported and taken care of. And then by extension, that makes the children be healthier and happier and better. And so that’s one of the main reasons. When I had my kid, I was lucky enough that in the city that I was living, they had a grant program that they would send a nurse to see you for one visit.

 

00;18;58;18 – 00;19;19;17

Dr. Mona

And I just thought that was like the most amazing thing that ever happened to me when I had my kids. And then fast forward, my kids are 18 and 17 now. But foster, you know, many years later, I was like, that’s the key. We need to bring that back to parent. And that’s one of the main reasons, too, that we chose to do it at home, because it’s just easier for mom and dad to.

 

00;19;19;17 – 00;19;38;12

Dr. Mona

Yeah, that is amazing. And there’s so many benefits to families with children. And like you said, postpartum lugging a child in a car seat in the snow. I appreciate Andrew for going in the snow on his bike or in a car, but that is so helpful to so many families. So I wanted to talk next about like structure of how it would work.

 

00;19;38;12 – 00;19;56;29

Dr. Mona

Right. Because I’m sure parents listening who’ve never even heard of this are like, well, how does it work with and like, is this something that is ever covered by insurance? Do they pay like a monthly fee? How do vaccines work? Emergencies like just kind of the basic stuff with payment, vaccines and emergency? It would be my question.

 

00;19;57;01 – 00;20;21;06

Dr. Andrew Elliston

Sure. That’s a really good question. One we’re very used to answering. I hate to throw this out there again, but the definition of concierge can mean different things to different or different practices. And so there is no one size fits all. So some practices will take only out-of-pocket cash payments. Some will work with insurance. To a certain extent.

 

00;20;21;09 – 00;20;57;19

Dr. Andrew Elliston

Our approach is the one we can speak to. And we take a hybrid approach. So we are in network with the major insurance providers, and we do submit billing to the insurance companies for all the medical care that they would normally pay for. They pay us the same as any traditional office that’s in network at a very discounted in-network contracted rate, which can be disappointingly low sometimes offices typically make up for that in sheer volume, which is why you see 4 or 5 kids an hour right?

 

00;20;57;21 – 00;21;20;12

Dr. Andrew Elliston

Yeah, to pay the bills. So we do work with insurance and we do that as a benefit to our families. It doesn’t do us a lot of favors because the insurance process is painful on the back end. And a lot of families don’t know that between the time, stress, expense and staff that it involves, we’re really doing it as a service to the families.

 

00;21;20;15 – 00;21;48;05

Dr. Andrew Elliston

So the insurance companies will pay for all the medical care, they’ll pay for the appointments, they’ll pay for the vaccines, they’ll pay for testing all the things they would normally pay for in an office. They will not pay for things that the insurance company doesn’t value, which is the extra time we can provide, the extra access and resources we can provide, the time and expense it takes for a doctor to actually travel to.

 

00;21;48;05 – 00;22;15;20

Dr. Andrew Elliston

You know, I spend more time traveling than I mean to spend an hour seeing a patient in their home. I will travel 15 or 20 minutes on each end of that appointment, rather, that’s for one appointment. And so you could see the scale is very different than in an office to pay for all that, we do have a flat fee that we charge separately on the side that covers everything that the insurance doesn’t cover.

 

00;22;15;21 – 00;22;16;11

Dr. Mona

Yeah.

 

00;22;16;14 – 00;22;22;23

Dr. Andrew Elliston

Again, actually, all the medical care we submit through insurance, just like traditional practices I see.

 

00;22;22;23 – 00;22;43;02

Dr. Mona

So in this. Yeah. In a structure. So they would pay like a monthly fee for the service of, you know, having you come to the home and doing all the, phone calls, all that. But then the insurance would cover vaccination. So the family is not paying extra for vaccines or extra for any of the things that they would normally get in an office.

 

00;22;43;05 – 00;23;08;08

Dr. Mona

Right. And it’s also a flat fee. So like this way, you know, God forbid your baby needs everyday visits because they have like high bilirubin and they, you know, you need to do testing. You know, we wouldn’t charge you additional because you need a ten visits as opposed to the other person that needed three visits, let’s say kind of fluctuates, as you know.

 

00;23;08;15 – 00;23;30;15

Dr. Mona

You know, especially the first five years of life, the kids are either needing a lot of visits because of the developmental milestones and vaccines and everything, or they’re sick all the time. Now. Then they get a little bit older, and maybe you only see them a few times a year, but then they get into school and a lot of the social and emotional stuff, you know, they need a lot of support with.

 

00;23;30;15 – 00;23;51;04

Dr. Mona

So it kind of fluctuates in the lifespan. So what we do is just keep it a flat fee. That’s very, very particular for us. And I guess we do it that way because we’re not very good business people, because a we’re just parents and, you know, we’re parents and we are medical professionals. We want to really make a difference.

 

00;23;51;04 – 00;24;10;21

Dr. Mona

So I know for a fact that we are really on the more manageable end of the spectrum as far as finances go than other practices, but that’s just how we choose to do it. And then things like, so if a child like you mentioned Billy Rubin, or to say an older child who needed blood work for some reason.

 

00;24;10;21 – 00;24;21;27

Dr. Mona

So blood work, obviously imaging, where would they go to do that? Would that be something like if it’s an emergency, they’d go to the E.R.. Does your practice have like blood work capabilities if that’s, needed?

 

00;24;21;29 – 00;24;29;20

Dr. Andrew Elliston

Yeah, it’s sort of all of the above. I mean, places that we have learned their experience do a much better job for children.

 

00;24;29;27 – 00;24;30;19

Dr. Mona

Yeah.

 

00;24;30;21 – 00;24;55;24

Dr. Andrew Elliston

Than adults, for example. And so that’s a particular filter for the kinds of services you can find. But we have places that we do send children to get imaging and tests done. Depending on what the issue is, we can and do blood work and testing that we’re doing it ourselves at the home. And it really depends on the scenario and the age and sometimes the kind of test.

 

00;24;55;26 – 00;25;23;06

Dr. Andrew Elliston

And then we also have a really fancy, I would say, telemedicine kit that our families have. And that also goes a very long ways towards improving the access and ability to provide the care and evaluations. We can do. It’s really it’s small. It’s useful when they travel, which is originally why we got it. And then we actually got ourselves set up with it right before the pandemic hit.

 

00;25;23;06 – 00;25;48;25

Dr. Andrew Elliston

And the world closed down. So to be really helpful for that too. But it lets us listen to the lungs and the heart and look in the ears and the throat and do things over the computer, then in some ways actually provides a better exam than what you and I can even do in person. So we have a lot of things that we can provide to our families that we’ve put a lot of research and work into.

 

00;25;48;27 – 00;26;08;12

Dr. Mona

Yeah. That’s fascinating. I mean, to me, the technology advancements and the fact that this is even a possibility and I love it, I just think it’s so great. And I think it’s something that is so important for parents to hear if it’s an option for them, you know, to see if that’s something that they want to have, if they want that level of involvement with the pediatrician.

 

00;26;08;12 – 00;26;40;21

Dr. Mona

I mean, I see so many benefits if it’s something that’s available in a family’s area and also like we started off with for the doctor or provider themselves, like it’s amazing. So just to kind of summarize, what would you say then from everything that you mentioned, obviously we talked about the patients and what you love. What would you say is like the number one thing that if you could say why you would want other pediatricians to be in concierge medicine, or why a family should be in a concierge practice, like, what is the biggest thing that you feel like is so valuable from at all?

 

00;26;40;24 – 00;27;04;14

Dr. Andrew Elliston

The bottom line is it’s the quality of care. Amazing is just better, which is extremely rewarding for me as a pediatrician because I know what they’re getting out of that. And the families learn and understand it as well, especially if they’re traveling. And while they’re traveling, they wind up having to go see a local pediatrician in a regular office.

 

00;27;04;17 – 00;27;06;02

Dr. Andrew Elliston

They get to see the other side of it.

 

00;27;06;03 – 00;27;06;24

Dr. Mona

Yeah.

 

00;27;06;26 – 00;27;30;00

Dr. Andrew Elliston

And that’s really the key. It boils down to quality of care, which is always our priority. Every decision we make and how we operate, the practice is focused on that. We will take the hit on something personally or for the practice. If it means that we can enhance the quality of care and outcomes for our families, because that’s really our priority.

 

00;27;30;03 – 00;27;51;03

Dr. Mona

Well, that is what I want. So much for medicine to change. And you’re right, we mentioned this at the beginning. It’s such a sad reality that I think so many young families and people who are, you know, having kids now and just seeing medicine right now, a lot of them either blame their pediatrician or feel like their pediatrician doesn’t listen to them or knows anything.

 

00;27;51;08 – 00;28;17;15

Dr. Mona

And I actually disagree. I actually think their pediatrician knows a lot and is capable, but we don’t have a system set up for us to allow the time to teach and educate and empower and do all the things that you’re able to do with the time that you’re given now. And I think that’s just so awesome that you’re able to kind of create that new reality for pediatric medicine, and also just kind of reclaim your love for, went to school for, and what you love to do.

 

00;28;17;17 – 00;28;43;10

Dr. Andrew Elliston

Yeah, I agree, I mean, I get so much personal value out of this kind of work. I really enjoyed working in the office where we were together. I got a lot out of that too, but this is like a whole nother level of reward for me internally. And I agree. Pediatricians across the board know an enormous amount. They care so much.

 

00;28;43;10 – 00;28;54;19

Dr. Andrew Elliston

That’s why they’re in the trenches doing the work that they’re doing. But a lot of it gets lost in the shuffle and lost in the system. And that’s really unfortunate.

 

00;28;54;21 – 00;29;11;23

Dr. Mona

Yeah. And I think one of the biggest things so you all star in pediatrics is obviously based in New York City. If someone’s listening and they’re not in New York, how can they even start to find someone? I’m sure. Is it just an internet search, or is there like a database to find a concierge pediatric practice, if they’re interested?

 

00;29;11;26 – 00;29;36;09

Dr. Andrew Elliston

It’s, also a very good question. Part of what’s really valuable to me is that our growth in our practice has been almost exclusively through word of mouth. So, our patients and their parents, we’ll talk to their friends or their family and personally recommend us. And that means so much to me, honestly, means we’re doing this right.

 

00;29;36;11 – 00;30;00;05

Dr. Andrew Elliston

So a lot of the spread of a practice like ours will come through word of mouth. And so I recommend that people actually talk to their friends and talk to their family. Maybe it’s not a concierge practice, but it’s a traditional office based practice that they love. If there’s someone who has the same values and priorities that you do, then take that at face value and strongly consider it.

 

00;30;00;08 – 00;30;21;05

Dr. Andrew Elliston

There’s not really a database or central hub for concierge medicine, and I think part of that is because there’s so many varieties of it. That you can certainly start with a Google search. Online groups, especially some of the mom groups I know, in particular New York City, that’s a very big thing, are a good resource to at least start.

 

00;30;21;07 – 00;30;41;12

Dr. Andrew Elliston

And then I would really strongly recommend that anybody who is interested find someone who sounds like they’re providing the concierge medicine service that you want, do your due diligence. Not everyone does the same thing, despite how they advertise themselves.

 

00;30;41;14 – 00;31;01;22

Dr. Mona

And I want to recognize the real life work from home of the dog barking. And I think that is that is the reality that we’re not going to edit out, because that’s just what we do here. Yeah, that’s life, I love it. This is so great. I, you know, every time I end an episode, I like, like to do something kind of random in terms of like asking your question to you that there’s nothing to do with what we talked about.

 

00;31;01;25 – 00;31;20;09

Dr. Mona

And I want to obviously share where people can find you and your website. But my surprise question for this episode is, tell me your biggest parenting fail and your biggest parenting victory, because I know you are also a parent, so nothing business related, nothing really to pediatrics. But what would you tell our listeners to make this more real?

 

00;31;20;09 – 00;31;24;25

Dr. Mona

Because, kind of going along with the dog barking.

 

00;31;24;27 – 00;31;33;07

Dr. Andrew Elliston

Yeah, my real life is gritty. Yeah, those are kind of hard questions because honestly, as a pediatrician, I should be a perfect parent, right?

 

00;31;33;10 – 00;31;39;19

Dr. Mona

Oh, yeah. What do you mean? Our kids are do everything we say. Yeah. No way.

 

00;31;39;21 – 00;32;09;26

Dr. Andrew Elliston

I think the biggest, like, parenting fail, I guess you could say, is it really feels like the last two years, the pandemic has been traumatizing to everyone on an individual level. On a family level at this point, really a global level. And all we’ve been able to do, like anyone else, is do our best. Yeah. And despite our very best efforts, both of our children actually caught Covid.

 

00;32;10;08 – 00;32;36;19

Dr. Andrew Elliston

They did well and they got through it, but it was really scary. And it happened before they were able to even be vaccinated. Yeah. Right now we didn’t know what the complications could be, including due to preexisting health conditions. And I mean, it’s stressful. Heidi and I have managed to take care of our kids through Covid and see patients through Covid and not catch Covid.

 

00;32;36;21 – 00;33;08;14

Dr. Andrew Elliston

You know, we’re prepared for that eventually happening. But yeah, it’s a struggle. They’re teenagers, and a lot of what they need is just social experience with their friends in high school. And that got taken away and they’re not dealing for that happened. But we had to invest a lot personally, emotionally in trying to help maintain, like their mental health and their academic success, which, you know, pretty much everybody in the country took a hit on over the last two years.

 

00;33;08;14 – 00;33;26;04

Dr. Andrew Elliston

And it’s been hard and I know it has been for everyone, but it’s hard to think about the last two years and feel like we didn’t fail our kids. Yeah. Or the other. You know, they’re doing well at this point and things are working out and, you know, we can see the light at the end of the tunnel.

 

00;33;26;07 – 00;33;57;19

Dr. Andrew Elliston

But that’s probably the biggest failure that we feel. I know I do. On the flip side, brighter side, the parenting victory that I value the most. And this is something I try to help our families do from day one. We have a really good relationship with our kids, open communication and good understanding, and they approach us with questions and concerns that a lot of kids would keep private and not tell anyone, much less their parents.

 

00;33;57;22 – 00;34;21;07

Dr. Andrew Elliston

And we can’t even try to help them or support them. If we don’t know something is wrong or something is going on or something that’s bothering them, and the quality of the relationship that we have, and that open level of communication is hands down the biggest parenting victory. I think that we have, and that goes back years to build that.

 

00;34;21;10 – 00;34;24;04

Dr. Andrew Elliston

But yeah, that’s been extremely valuable.

 

00;34;24;06 – 00;34;44;19

Dr. Mona

And that is what I hope to see for my child. That’s amazing. And Andrew, I miss you. It was so great working with you for the couple of years that we worked together. And like you said earlier, we learned so much from that experience. And although you have moved on to do this, like there’s so much that we learned from that, there’s so much that you get to learn from this experience, being a practice owner, if you will.

 

00;34;44;21 – 00;35;02;07

Dr. Mona

Thank you so much for joining me today. Everybody listening. Elliston Pediatrics on Instagram. If you want to learn more about the practice, especially if you’re in New York and you’re interested in becoming a patient, I know it depends on what month, what’s going on, whether you guys are accepting new patients, correct?

 

00;35;02;20 – 00;35;22;27

Dr. Andrew Elliston

Yes. Because we value the quality of the care we can provide. So much we have at various points, hit pause and said we can’t take a new patient for now. We are currently taking new patients, and we’re always happy to talk to families and even just provide some education well before they even consider joining us. So everybody is.

 

00;35;22;27 – 00;35;45;13

Dr. Mona

Amazing. Well, I’m going to link the Instagram handle as well as their website, Elliston Pediatrics and Andrew and Heidi, thanks again for joining me on this episode. I just one love to share this whole practice model with people who may not be familiar and too selfishly. I just love reconnecting with you both because, I’ve never met Heidi, but of course I know Andrew very well from work.

 

00;35;45;13 – 00;35;56;20

Dr. Mona

And so really, I’m so proud of what you’re doing. I hope more people can be inspired to follow their dreams, even if it’s not starting a concierge practice to reclaim their joy. So thanks again for joining me today.

 

00;35;56;23 – 00;36;04;07

Dr. Andrew Elliston

Guys. Thank you very much. It was really nice to reconnect with you, and I’m proud to see what you’ve accomplished with your podcast.

 

00;36;04;09 – 00;36;17;24

Dr. Mona

Oh thank you. And when I’m back in New York, will have to reconnect again because I’m hoping with this pandemic easing, hopefully we need more ease. I want to come back and we have to reconnect because I yes, I definitely can’t wait to give you both a big hug.

 

00;36;17;26 – 00;36;18;17

Dr. Andrew Elliston

Probably. Yep.

 

00;36;18;19 – 00;36;22;06

Dr. Mona

Yeah, yeah. Have a great day.

 

00;36;22;09 – 00;36;22;25

Dr. Andrew Elliston

Or a good day.

 

00;36;22;28 – 00;36;38;18

Dr. Mona

Thank you for tuning in for this week’s episode. As always, please leave a review, share this episode with a friend, share it on your social media. Make sure to follow me at PedsDocTalk on Instagram and subscribe to my YouTube channel, PedsDocTalk TV. We’ll talk to you soon.